KINGMAN CBOC (1696)    INSTITUTION (4)

Name Value
NAME KINGMAN CBOC
STATE ARIZONA
STREET ADDR. 1 2668 HUALAPAI MOUNTAIN ROAD
CITY KINGMAN
ZIP 86401-8387
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME KINGMAN VA CBOC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1770539561
TAXONOMY CODE
LOCATION TIMEZONE MOUNTAIN
COUNTRY USA
TIMEZONE EXCEPTION SST Only
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 649GA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1770539561
  • CODING SYSTEM:   VASTANUM
    ID:   649GA
  • CODING SYSTEM:   CLIA
    ID:   03D1017041